Title Page

  • Inspector Name:

  • Inspection Date:

Emergency & First Aid

  • Fire alarm stations clearly marked and readily accessible

  • Fire alarms free from visible damage

  • Lights above emergency exits have all bulbs lit

  • Walking paths clear of obstructions

  • "Crash Bars" operate easily on emergency exits

  • Signs showing locations of fire extinguishers clearly visible

  • Fire extinguishers are easily accessible

  • Fire extinguishers fully charged

  • Signs showing locations of first aid kits clearly visible

  • First aid kits are readily accessible

  • First aid kits are sufficiently stocked

  • First aid kits are free of expired items

  • Signs showing locations of emergency eyewash stations/showers clearly visible

  • Emergency eyewash stations/showers are readily accessible

  • Emergency eyewash stations/showers are fully functional

  • SDS materials are clearly marked and readily accessible


  • Ladders are in good condition and free from damage or defect

  • Ladders in use are being used safely and appropriately

  • Are workers standing on top rungs or platforms?

  • Are tools/equipment being left unattended on platforms?

  • Are step ladders are being used as straight ladders?

  • Are workers climbing ladders failing to use 3 points of contact while climbing?

Machinery, Equipment & Power Tools

  • All guards in place and fully operational

  • Storage units attached to machinery using proper fasteners

  • Safety placards in place and legible

  • Lock-Out/Tag-Out kits in place and complete

  • Insulation on wiring is intact with no cuts or breaks

  • There is at least 3 feet (36 inches) of clearance in front of electrical panels

  • All electrical equipment and personal tool boxes requiring power are plugged directly into wall outlets

  • All cords and plugs are free from damage and defect

  • All circuit breaker panels are free of combustible materials

  • "Warning High Voltage" signs are properly installed on all high voltage enclosures

  • Flammable cabinets are clearly marked and in good working condition

Personal Protective Equipment

  • Eye protection is in good working order

  • Does eye protection have clear vision?

  • Does eye protection have excessive scratches or pitting in the lenses?

  • All grinders have face shields available

  • All workers in designated areas wear safety footwear

  • Hearing protection is worn while working with tools/machines listed in the Hearing Conservation Plan

  • PPE is readily available and in good working order for all personnel, including visitors to the area

  • PPE is properly stored when not in use


  • Bathrooms and employee break areas are clean and free from litter/refuse

  • Soap and paper towels are available in bathrooms and employee break areas

  • Soap and paper towels are available at any sink used for employee hygiene

  • Refrigerators are in good working order

  • Refrigerators have no spoiled/expired food

  • Refrigerators are clean and without odor

Work Area General Check

  • All areas receive adequate lighting

  • All electrical outlets are GFCI protected

  • Carpets and throw rugs are free of tears or trip hazards

  • Handrails are on all fixed stairways

  • Handrails are free of damage or defect

  • Standard guard rails are provided wherever aisle or walkway surfaces are elevated more than 4 feet (48 inches) above any adjacent floor, surface, or the ground

  • All furniture is in good working order

  • All furniture is free from damage or defect

  • There are no prohibited items (food, coffee makers, ovens/microwaves, etc.) present on work shop floor

Hazardous Chemicals

  • All solvents, cleaning supplies, lubricants, etc. have warning labels

  • Ventilation fans have been tested and in proper working condition providing adequate air movement in areas where solvents are used

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.